Resources Resources

HIPAA Standard Code Set


Plus about 100 additional codes sets in the X12 formats

Claim Adjustment Reason Code Set

Click here to open the Washington Publishing Company's website for a complete list of the EDI Claim Adjustment Reason Codes used on provider payment vouchers.

Code Set Implications

Code set analysis must be conducted:
  • Local codes are eliminated; translate to standard code set
  • CPT-4 and HCPCS will overlap for physician services.
  • CPT-4 for inpatient procedures now ICD-9-CM
  • Must continuously stay abreast of all changes and communications on medical and non-medical code sets.